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. 2024 Sep 30;25(10):1351-1359.
doi: 10.1093/ehjci/jeae197.

Pericoronary adipose tissue for predicting long-term outcomes

Sophie E van Rosendael  1 , Vasileios Kamperidis  2 , Teemu Maaniitty  3 , Michiel A de Graaf  1 , Antti Saraste  3   4 , George E McKay-Goodall  5 , J Wouter Jukema  1   6 , Juhani Knuuti  3 , Jeroen J Bax  1
Affiliations

Pericoronary adipose tissue for predicting long-term outcomes

Sophie E van Rosendael et al. Eur Heart J Cardiovasc Imaging. .

Abstract

Aims: Pericoronary adipose tissue (PCAT) attenuation obtained by coronary computed tomography angiography (CCTA) has been associated with coronary inflammation and outcomes. Whether PCAT attenuation is predictive of major adverse cardiac events (MACE) during long-term follow-up is unknown.

Methods and results: Symptomatic patients with coronary artery disease (CAD) who underwent CCTA were included, and clinical outcomes were evaluated. PCAT was measured at all lesions for all three major coronary arteries using semi-automated software. A comparison between patients with and without MACE was made on both a per-lesion and a per-patient level. The predictive value of PCAT attenuation for MACE was assessed in Cox regression models. In 483 patients (63.3 ± 8.5 years, 54.9% men), 1561 lesions were analysed over a median follow-up duration of 9.5 years. The mean PCAT attenuation was not significantly different between patients with and without MACE. At a per-patient level, the adjusted hazard ratio (HR) and 95% confidence interval (CI) for MACE were 0.970 (95% CI: 0.933-1.008, P = 0.121) when the average of all lesions per patient was analysed, 0.992 (95% CI: 0.961-1.024, P = 0.622) when only the most obstructive lesion was evaluated, and 0.981 (95% CI: 0.946-1.016, P = 0.285) when only the lesion with the highest PCAT attenuation per individual was evaluated. Adjusted HRs for vessel-specific PCAT attenuation in the right coronary artery, left anterior descending artery, and left circumflex artery were 0.957 (95% CI: 0.830-1.104, P = 0.548), 0.989 (95% CI: 0.954-1.025, P = 0.550), and 0.739 (95% CI: 0.293-1.865, P = 0.522), respectively, in predicting long-term MACE.

Conclusion: In patients referred to CCTA for clinically suspected CAD, PCAT attenuation did not predict MACE during long-term follow-up.

Keywords: atherosclerosis; coronary artery disease; coronary computed tomography angiography; major adverse cardiac event; pericoronary adipose tissue.

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Conflict of interest statement

Conflict of interest: The Department of Cardiology of Leiden University Medical Center received research grants from Abbott Vascular, Bayer, Biotronik, Boston Scientific, Edwards Lifesciences, GE Healthcare and Medtronic. J.J.B. received speaker fees from Abbott Vascular, Edwards Lifesciences, and Omron. J.W.J. received research grants from and/or was speaker (with or without lecture fees) on a.o.(CME accredited) meetings sponsored by Amarin, Amgen, Athera, Biotronik, Boston Scientific, Dalcor, Daiichi Sankyo, Lilly, Medtronic, Merck-Schering-Plough, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi Aventis, the Netherlands Heart Foundation, CardioVascular Research the Netherlands (CVON), the Netherlands Heart Institute, and the European Community Framework KP7 Programme. J.K. received consultancy fees from GE Healthcare and Synektik Pharma and speaker fees from GE Healthcare, Bayer, Lundbeck, Boehringer-Ingelheim, Pfizer, and Merck, outside of the submitted work. A.S. received consultancy fees from Astra Zeneca and Pfizer and speaker fees from Abbott, Astra Zeneca, BMS, Janssen, Novartis, and Pfizer. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
A bar chart demonstrating the mean PCAT attenuation per-patient level analyses. Values in HUs are presented as mean ± SD.
Figure 2
Figure 2
A bar chart demonstrating the mean PCAT attenuation among coronary lesions. The mean PCAT attenuation per lesion stratified by vessel (A) and location within vessel (B) of patients with MACE vs. those without MACE. Values in HUs are presented as mean ± SD.
See this image and copyright information in PMC

Comment in

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